Warm, brown and gooey; no unfortunately I am not describing a beautiful chocolate dessert, I am however describing a new form of medicine… poop. Poop, it’s stinky, brown and flat out not that appealing, so why would anyone ever suggest consuming something that just came out of another person. Well Fecal Microbiota Transplant is giving a completely new meaning to the ‘bitter pill’, but what is it and is consuming fecal matter really helping us at all?
If you’ve ever found yourself in need of antibiotics to get over a really nasty bacterial infection, you may or may not of known that those antibiotics not only kill unwanted, harmful bacteria but also bacteria that is beneficial to your body. Which, leaves your body vulnerable to some other nasty infections that your ‘good’ bacteria would of otherwise protected you from. When antibiotics are introduced to the body they alter the normal bacterial flora of your intestine and thereby reduce the resistance to the colonisation of opportunistic pathogens which would otherwise remain dormant due to the presence of beneficial bacteria. This in turn can have some relatively uncomfortable effects on your body such diarrhoea, nausea and vomiting; thrush for women is often a common side effect, however the side effects of greatest concern are those that come about due to the presence of Clostridium difficile (C. difficile). C. difficile is a bacterium that is usually found living passively in the intestines of many individuals along with many other types of bacteria, however the introduction of antibiotics means that C. difficile is able to thrive and multiply potentially causing Clostridium difficile colitis.
Clostridium difficile colitis is the inflammation of the large intestine and is a common cause of diarrhoea, this at a glance seems relatively harmless but over the years Clostridium difficile infection has become more prevalent in the USA and Europe and more aggressive in it’s ability to withstand standard treatment. Clostridium difficile infection is usually treated with antibiotics, however new strains of C. difficile have become resistant to traditional treatments making it harder to treat C. difficile . This infection in older and more susceptible individuals can cause hospitalisation over a prolonged period of time and in some cases death, with statistics from an article from the Scandinavian Journal of Infectious Diseases displaying that death certificates indicating Clostridium difficile infection as a primary or contributory cause of death has increased by about 50% in Sweden. So with standard treatments becoming less and less successful this is where the poop comes into play (please do not play with poop).
There are two ways you can approach faecal microbiota transplantation; faeces from a healthy donor (spouse or close relative) is collected and it is either crafted into a tablet and then ingested or introduced to the body via the other hole… Okay its a little more complicated then that but it isn’t any bit less disgusting. In technical terms Fecal microbiota transplantation is the transfer of fecal material containing bacteria and natural antibacterials from a healthy individual into a unhealthy recipient and it appears to be working! A paper in the Journal Of Digestive Diseases has stated that case reports and small case series suggest that recurrent Clostridium difficile infection can be cured with a single treatment. In a study from the Scandinavian Journal of Infectious Diseases, 31 test patients which had been suffering from Clostridium difficile infection displayed a response rate of 74% in patients treated with faecal transplantation.
So it looks like this treatment isn’t just a load of crap… Faecal microbiota transplantation has some strong evidence behind it, and with the use of antibiotics becoming more common it looks like this mode of recovery is only going to get bigger and bigger.
So would you ever try this treatment?
Brown, WR 2014, ‘Fecal microbiota transplantation in treating Clostridium difficile infection’, Journal Of Digestive Diseases, 15, 8, pp. 405-408, MEDLINE Complete, EBSCOhost, viewed 8 May 2016.
Day, J 2016, Fecal Transplantation (Bacteriotherapy): Johns Hopkins Division of Gastroenterology and Hepatology,<http://www.hopkinsmedicine.org/gastroenterology_hepatology/clinical_services/advanced_endoscopy/fecal_transplantation.html>
Emanuelsson, F, Claesson, B, Ljungström, L, Tvede, M, & Ung, K 2014, ‘Faecal microbiota transplantation and bacteriotherapy for recurrent Clostridium difficile infection: A retrospective evaluation of 31 patients’, Scandinavian Journal Of Infectious Diseases, 46, 2, pp. 89-97, Academic Search Complete, EBSCOhost, viewed 8 May 2016.
Thefecaltransplantfoundation.org., 2016, What is FMT?: The Fecal Transplant Foundation, <http://thefecaltransplantfoundation.org/what-is-fecal-transplant/>